Imaging Sci Dent.  2015 Mar;45(1):15-22. 10.5624/isd.2015.45.1.15.

Reproducibility of the sella turcica landmark in three dimensions using a sella turcica-specific reference system

• Pittayapat P
• Jacobs R
• Odri GA
• Vasconcelos KdF
• Willems G
• Olszewski

• KMID: 2116787
• DOI: http://doi.org/10.5624/isd.2015.45.1.15

Abstract

PURPOSE
This study was performed to assess the reproducibility of identifying the sella turcica landmark in a threedimensional (3D) model by using a new sella-specific landmark reference system.
MATERIALS AND METHODS
Thirty-two cone-beam computed tomographic scans (3D Accuitomo(R) 170, J. Morita, Kyoto, Japan) were retrospectively collected. The 3D data were exported into the Digital Imaging and Communications in Medicine standard and then imported into the Maxilim(R) software (Medicim NV, Sint-Niklaas, Belgium) to create 3D surface models. Five observers identified four osseous landmarks in order to create the reference frame and then identified two sella landmarks. The x, y, and z coordinates of each landmark were exported. The observations were repeated after four weeks. Statistical analysis was performed using the multiple paired t-test with Bonferroni correction (intraobserver precision: p<0.005, interobserver precision: p<0.0011).
RESULTS
The intraobserver mean precision of all landmarks was <1 mm. Significant differences were found when comparing the intraobserver precision of each observer (p<0.005). For the sella landmarks, the intraobserver mean precision ranged from 0.43+/-0.34 mm to 0.51+/-0.46 mm. The intraobserver reproducibility was generally good. The overall interobserver mean precision was <1 mm. Significant differences between each pair of observers for all anatomical landmarks were found (p<0.0011). The interobserver reproducibility of sella landmarks was good, with >50% precision in locating the landmark within 1 mm.
CONCLUSION
A newly developed reference system offers high precision and reproducibility for sella turcica identification in a 3D model without being based on two-dimensional images derived from 3D data.

Keyword

Cephalometry; Cone-Beam Computed Tomography; Orthodontics; Sella Turcica; Imaging, Three-Dimensional

MeSH Terms

Cephalometry
Cone-Beam Computed Tomography
Imaging, Three-Dimensional
Orthodontics
Retrospective Studies
Sella Turcica*

Figure

• 

  Fig. 1 (A) and (B) show a threedimensional model of one patient in a top and oblique overview, respectively. In this figure, a reference system is created by locating four landmarks (the right and left anterior clinoid process [ACP] and the right and left apex of the petrous part of the temporal bone right [APT]). (C) is a close-up of the top view presented in (A), showing the landmarks that form the reference system: (a) right and left ACP, (b) right and left APT, and (c) one of the sella landmarks. (D) is a close-up of the oblique view, showing landmarks (a), (b), and (c). The sella landmark (c) was located on one of the vertical planes created from the reference system in the Maxilim® software.

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